The ETHICS project
The ETHICS project (ElecTronic Health In ContextS), is a two years PRIN project (Research Projects of Relevant National Interest – Call for proposals 2022 PNRR), coordinated by the University of Milan and involving the University of Bergamo and the Marche Polytechnic University, Italy.
As part of a systemic approach to health, the project explores the possibilities of a socio-technical and patient-centred interpretation of telemedicine. The proposal is in line with the interventions envisaged by the National Recovery and Resilience Plan (or NRP) which, in line with the territorial care reform, aims to reduce territorial inequalities and improve integration between regional health services and national platforms through innovative solutions. The development of telemedicine is one of the strategic interventions planned to ‘make the home the first place of care’. Furthermore, besides contributing to the ‘Health’ cluster of Horizon Europe, the proposal affects many key activities of the NRP (National Research Plan) 2021-27, as they require a greater understanding and development of telemedicine.
Currently, a technical, biomedical approach still prevails in telemedicine practices. This approach frames technologies as simply (and neutrally) supporting care, and maintains a reductionist view of diseases as biological accidents or biochemical imbalances. However, complementary approaches have been developed for some time. They view health and illness as a social system property rather than individual conditions, emphasising the role of communities of practice (Lave & Wenger 1991) of physicians, patients, family members, nurses, administrators, volunteers, paramedical and psychological support associations (Mol 2002). All these interconnected social worlds contribute to the health, illness and recovery of individual patients.
In this perspective, the performance and effectiveness of e-health technologies depend on their inclusion in enabling contexts. The material and symbolic resources that health professionals and the patient’s social world are able or unable to mobilise are constitutive of these enabling contexts. Based on a socio-technical and patient-personalised approach, commonly adopted in Science and Technology Studies (STS) and Sociology of Health and Medicine (SHM), the proposal aims to study some innovative cases of implementation of remote therapies related to two diseases: oncology and COVID-19. The study will apply a mixed and multi-method approach, using three different methodologies:
- 1 web survey (on attitudes and practices towards telemedicine) addressed to Italian General Practitioners;
- 4 case studies;
- 1 Delphi group with public health and telemedicine experts.
In addition to academic communities, the proposal aims to stimulate the creation/aggregation of clinical and healthcare communities, which deal with individual diseases.
One of the outcomes of the proposal is a community of practice sharing experiences of successful telemedicine practices. If they are replicable and adaptable in other contexts, they could represent a model for the transfer of innovative technology and medical practice.